Policyholders who are invited to take an examination under oath must employ experienced real estate insurance lawyers. This is especially true when an insurance company indicates that a fire is suspected or intentionally lit. Merlin Law Group has collected many typical questions asked by the insurance company's lawyers. Policyholders should know what questions will be asked in advance before going to the survey under oath.
As stated in Participate in the requested survey under oath! :
An insurance company may have the right to examine its insured under oath in connection with its investigation and evaluation of an insurance claim. Most insurances entail an obligation for the insured to cooperate in the follow-up investigation. An insured's failure or refusal to fulfill an obligation to cooperate by submitting to an investigation under oath (“EUO”) may preclude recovery against the insurance company.
Since policyholders will usually not avoid this requirement, the next question is how to prepare for it and understand that the insurance company is not just doing this as an exercise but looking for a formal excuse not to pay damages. The warnings in our previous blog post, Typical questions asked during an investigation or a sworn statement under oath of a disputed structural or personal value claim suspected to be inflated, exaggerated or made up should be read carefully: [1
If the carrier considers the claim to be black letters, their questions will focus on several areas, including the insured's finances. You can expect them to ask for tax returns, monthly debt invoices, loan documents, credit card summaries and similar items. Rest assured, a good fraud lawyer will ask the policyholder to account for their monthly / annual income compared to their debts, with a deficit showing financial distress and thus a motive for committing insurance fraud.
The carrier will also ask questions about previous insurance claims to see if there were areas of damage from a previous claim that were not fully repaired and for which the insured is seeking double recovery. In this situation, if the policyholder does not have proof of previous repairs, this poses a serious problem, as it really strengthens the position of the carrier. Furthermore, the carrier will ask questions and apply for documents on all previous insurance claims from the insured. As it is likely that a good person may suffer a covered loss, it is essentially unlikely that a good person will suffer several insurance losses. Believe it or not, there are people out there who are serial insurance fraudsters who look at insurance as a contract for supplemental income. Like the scams of the serial claims, it is the people who have a loss and are trying to extend its reach to, for example, renovate a kitchen or bathroom. All public adjusters and lawyers should take a genuinely skeptical view of a claim about the damage overlapping areas for renovation or where the extent of the loss appears to be excessive. Policyholders should know that even if any contractor can give them a wink and a nod about including an undamaged bathroom in their work with an eye to the insurer subsidizing that work, at the end of the day it is the policyholder on the hook for that fraud. Thus, all policyholders should be able to easily answer questions about when renovations began, when they were completed, and proof of payments so as not to fall under the yellow eyes of fraud.
The last corral that the carrier can try to fight alleged frauds is by not mitigating. Even if a failure really is not fraud – unless the insured lied about making repairs or when the repairs were carried out – it really is the ugly sister of the fraud. That is, often when the carrier cannot properly prove the fraud charge, it can reduce its liability by showing that the insured did not carry out proper temporary repairs to prevent the damage from deteriorating, which is of course an obligation after loss of all property insurance.
Make sure that answers to questions about content and business claims are correct. Many training manuals for insurance companies now emphasize that it is easier to prove fraud when submitting content claims. Most policyholders do not know the history and value of all personal property and stock. If it burns to ashes, memories are often wrong. The number, age, value and condition of many personal items are often "best guesses" that insurance companies or their lawyers will make mistakes if they are wrong. Be careful with content claims. This is not a new trend but one that we warned about seven years ago in Misrepresentation of personal property claims can cost. . . LARGE :
One of the most difficult parts of property insurance claims is the content share of the claims. Although the insured saved receipts to prove the age and cost of personal property, these receipts are often stored in the same public place as the personal property and suffer the same fate as the personal property. Consequently, policyholders and public adjusters are often left to estimate the age and cost of personal property. This often leads to a lot of disputes between the policyholders and their insurance companies.
The key point is when claiming content damage or theft, it is absolutely necessary that the claim is correct and verifiable. It is much better to leave dubious things out of a claim than to be responsible for fraud. To do differently is to play with fire …
To help policyholders, I enclose an insurance company's information sheet with some of the questions in a typical survey under oath. 1 If you are going to an investigation under oath, hire a law firm that has been to several investigations under oath and has any questions that you can review in advance.
Thought for the day
Rather fail with honor than succeed with fraud.
Song For The Day
1 Customer Information Form – Firefall (taken from EU Insurance Company) degree format).